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Intralesional Bleomycin in the Management of Low-flow Vascular Malformations - A Case Report
Pradeep Devadoss1, Megarasu Deepanjali1, Monica Parthiban1
1Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India.
Rationale:
Low-flow vascular malformations (LFVMs) of the orofacial region are rare congenital vascular anomalies caused by aberrant development of venous and lymphatic channels, leading to slow or stagnant blood flow. This report highlights the successful management of LFVMs of buccal mucosa using ultrasound-guided bleomycin sclerotherapy.
Patient Concerns:
A 37-year-old female presented with a 5-year history of progressive, painless swelling of the left buccal mucosa.
Diagnosis:
Clinical and radiological evaluation, including computed tomography (CT) angiography, confirmed a LFVM supplied by the left facial artery with venous drainage into the retromandibular vein.
Treatment:
The patient underwent three weekly sessions of ultrasound-guided intralesional bleomycin sclerotherapy (15 IU in 10 mL sterile water).
Outcomes:
One-year follow-up CT angiography showed minimal residual tissue with no recurrence and a 70% reduction in lesion size was noted.
Take-Away Lessons:
Ultrasound-guided bleomycin sclerotherapy is a safe, minimally invasive and effective treatment for LFVM in cosmetically sensitive facial regions.
